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now I see lots of tiny and mid-sized dots all over the body, that tend to itch a little which I try not to rub, but just massage them gently. It appears it is Atripla rash (have been on it for 11 months) and it's the first time I'm getting these rashes (of course some people can get them after a long time, while some soon enough and some never).

I have insurance but I can't run to an hiv doctor as I've had insurance for less than six months and with a pre-existing condition I don't think I'll get treatment regardless (if covered less than six month). The only option may be to slowly wean off Atripla and deal with whatever happens. Unless it's the Acyclovir that I'm taking for Shingles that's causing the rash. Guys, my mind is spinning and I'm trying to stay calm in all this.

Any thoughts or suggestions will be very much appreciated. It's amazing how soon the situation can change, my last lab work showed OK levels of liver function...

I picked the meds overseas by paying cash and my doctor is overseas in India. I picked almost a year's supply of which I only have 4-5 months supply left. Everytime I have talked to him (last time was two months ago) he says the same thing, no, you cannot stop the meds.

So, it's possible that liver function can go off the chart in less than two months? Without getting another test (pay from my pocket) I can't say. Isnt' prednisone an antihistamine? I'm taking 20 mg everday and it's a 21 day course.

To change meds I would have to see a hiv specialist here in US, and I'll run into the pre-existing condition limitation that will deny me meds, so that may not be an option until I finish my six months of employment.

Ah that explains a lot. Well I know nothing about the shingles drugs. I am not in health care whatsoever. I just shared my experience with rashes from HAART. Like you, doctors said never to stop, I just had to switch the next day to the new combo.Can't you call your Indian doc then and ask him what to do? What a dilemma. Can you go to a clinic where you are, for a consultation at least?

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

What JRE said about prednisone, it is a noted side effect and more likely as you have started the drug recently. It probably isn't doing much for your shingles anyway.

Efavirenz rash tends to happen at the beginning of treatment. You cannot diagnose a rash without other indicators,. In the case of efavirenz, liver markers are important (the test is cheap) cos this is the serious point of harm (if it is efavirenz).

If the rash blisters or you get fever it is an emergency.

There is no weaning off efavirenz. Stopping without other ARV cover carries a 50% resistance to the two most common NNRTIs, efavirenz (in Atripla) and nevirapine (Viramune).

Started the first dose of prednisone (3tabs all at once) this morning around 7:30am and the rashes do seem little worse around 12:30pm and onward...The dosage is 3tabs once daily for 1 week, then 2T daily for 1 week, then 1T daily for one week.

Started Acyclovir last night and took three doses (one last night and two today -it's a 1 tabx4 times a day).

Which also makes me to ask the question...is the prednisone also for shingles or it is just to get the swelling around the eyes down, the area most affected by shingles? Rather, if Prednisone is stopped, could it affect treatment of shingles with Acyclovir possibly?

Having shingles several times over the past 25 years, I was only given Acyclovir for that. However, I have been on Prednisone before, the only issues I had with that was some intense anxiety. Prednisone can be a tough drug to handle.

I am also wondering, if you might be able to drop the Prednisone. Something you should ask your doctor about.

It's possible most of you may have gone to bed by the time I post this but after four hours of waiting for the doctor and three calls later, all in vain, I was finally able to talk to the "on-call" physician who also did not seem the brightest tool in the shed.

His suggestion is to stop the Acyclovir and continue the Prednisone (which is anti-allergenic) even though I said I suspect it's the prednisone. But he didn't think so. So, I have to make a decision here in the next hour if I should follow his advice or my instinct (which has deceived me on occasion in the past).

So it seems quite certain that it's the Acyclovir that is giving me serious rashes over the body. The doctor also suspected that and had me stop this medicine for now. I am continuing to take Prednisone and since I have not taken Acyclovir all day today I do feel little relief with new rashes, though old ones are still there. It may be several weeks before they clear out.

We really are puppets in the hands of these doctors who are really looking at a computer screen, and doing click, click, click to get to a page where the system tells them what to prescribe. I could do a lot of clicking too and arrive at the same page.

There's still zero relief to the swelling in the eye which is sealed shut for three straight days now...one of the many collateral damages of this illness...

Six long hours at the doctor's, two of them actually, one regular MD and one eye-doctor this morning and the determination is that I need to get admitted to ER or to a hospital immediately. They are trying to find a suitable location that accepts my Anthem BC insurance. They want to give Acyclovir again, only through IV this time as I had a serious rash to the tablet form.

My other option is to try two new drugs, only one FDA approved but the hiv specialist warned that these drugs have had a substantial renal failure in quite a few people so he does not feel comfortable in giving them, but the risks and choice is mine.

So, in an hours time, off I go, to a brand new adventure. As one Son of God might say "Oh, Lord, why hast thou forsaken me"? but I'm not going there yet...I'm still counting my blessings...however small they may appear to be at the moment.

Adios all, If I make it, I'll stop by to say hi again, if I have to take the deadly drugs tied to renal failure, you can guess what happened.